RICKI UPENDRA SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

Title

First Name

RICKI

Middle

UPENDRA

Last Name

SHAH

Business Name

RICKI UPENDRA SHAH MD

Original Issue Date

04/22/2014

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021